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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348

S131

Conclusions

More research in this field is warranted.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.161

EW44

Hypomanic symptoms in mixed

depression – is DSM-5 wrong?

Evidence from the BRIDGE-II-MIX

study

D. Popovic

1 ,

, C . T

orrent

1 , E. V

ieta

1 , J.M

. Azorin

2 , J. A

ngst

3 ,

S. Mosolov

4

, C.L. Bowden

5

, A. Young

6

1

Unviersity Of Barcelona, Idibaps, Hospital Clinic, Psychiatry,

Barcelona, Spain

2

Hôpital Sainte-Marguerite, Psychiatry, Marseille, France

3

Psychiatric Hospital, University of Zurich, Psychiatry, Zurich,

Switzerland

4

Moscow Research Institute of Psychiatry, Psychiatry, Moscow,

Russia

5

University of Texas Health Science Center, Psychiatry, USA

6

King’s College, Psychiatry, London, United Kingdom

Corresponding author.

Introduction

DSM-5 criteria for the mixed features specifier

exclude symptoms, such as psychomotor agitation, irritability and

mood lability.

Objectives

The goal of the BRIDGE-MIX study was to provide

an estimate of the frequency of mixed states (MXS) in depressed

patients according to different definitions and to compare their

clinical validity.

Aims

The aim of this sub-analysis is to examine the importance

of distinct hypomanic symptoms in mixed depression, including

those excluded from DSM-5.

Methods

A total of 2811 subjects were enrolled in this

multicentric cross-sectional study. Psychiatric symptoms, socio-

demographic and clinical variables representing risk factors for

bipolar disorder (BD) were collected. Multiple comparisons anal-

ysis was performed using a Bonferroni-corrected threshold and

stepwise-backward logistic regression.

Results

Two hundred and twelve patients fulfilled DSM-5 criteria

for MXS. The most common symptoms in this subset and in the

total sample are shown in Table 1 (Tables are not available for this

abstract). Logistic regression demonstrated specific associations of

psychomotor agitation (Wald 5.092,

P

= 0.024), impulsivity (Wald

28.47,

P

< 0.0001), racing thoughts (Wald 12.657,

P

< 0.0001) and

logorrhoea/pressured speech(Wald 230.720,

P

< 0.0001) with DSM-

5 diagnosis of MXS (Table 2).

Conclusions

The DSM-5 definition ofMXS excludes “overlapping”

mood criteria, such as psychomotor agitation, irritability and mood

lability, among the most frequent features of mixed depression in

our sample and in literature. The results of this study highlight

the impact of the excluded symptoms on MXS diagnosis. Although

these symptoms may be non-specific, their exclusion from DSM-5

may not be justified, in the absence of evidence that the remaining

criteria are sufficiently sensitive to identify MXS.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.162

EW45

Towards a redefinition of dissociative

spectrum dimensions inside Capgras

and misidentification syndromes in

bipolar disorder: Case series and

literature review

M. Preve

1 ,

, P . S

alvatore

2 , M.

Mula

3 , E. F

avaretto

4 , M.

Godio

1 ,

R. Traber

1 , R.A

. Colombo

1

1

Sociopsychiatric Organization, Psychiatric Clinic, Mendrisio,

Switzerland

2

McLean Hospital, Department of Psychiatry, Harvard Medical

School, Boston, USA

3

Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St.

George’s University Hospitals NHS Foundation Trust, London, United

Kingdom

4

Krankenhaus Brixen, Zentrum für Psychische Gesundheit, Brixen,

Italy

Corresponding author.

Introduction

Misidentification phenomena and Capgras Syn-

drome (CS) occur in different psychiatric (psychotic or major

affective illnesses) and neurological (traumatic brain injury,

epilepsy, neurosyphilis, etc.) disorders

[1,2] . T

he aim of this report

is to redefine dissociative spectrum dimensions inside CS and

misidentification syndromes in patientswith Bipolar Disorder (BD).

Method

Five inpatientswere assessedwith the SCID-P, SCID-DER,

DSS, HRSD, YMRS, a neurological and general medicine review, a

first-level brain imaging examination (CT and/or MRI). We con-

ducted a systematic literature review (PubMed, Embase, PsychInfo)

using the key terms “Capgras Syndrome” and “Misidentificaition”.

Results

All patients were diagnosed with type-I BD and had con-

comitant CS that presented with misidentification phenomena in

the context of psychotic mixed state. They reported high scores for

autopsychic and affective depersonalization symptoms as well as

high SCI-DER (mean = 24.4) and DSS (mean = 13) total scores.

Discussion and conclusion

To our knowledge in literature, there

are not studies that evaluated dissociative spectrum symptoms in

CS in BD. This condition of identity and self fragmentation could

be the key to shedding light on the interconnection between affec-

tive and non-affective psychotic disorders from schizophrenia to

BD, and may underscore the possible validity of the concept of the

unitary psychosis proposed by Griesinger

[3–5] . F

urther research

is warranted to replicate our clinical and qualitative observations

and, in general, quantitative studies in large samples followed up

over time are needed. Methodological limitations are considered.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

References

[1] Fishbain DA, 1987.

[2] Salvatore P et al., 2014.

[3] Griesinger W, 1892.

[4] Reininghaus U et al., 2013.

[5] Kumbier E et al., 2010.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.163

EW46

Mapping vulnerability to bipolar

disorders

M.R. Raposo

1 ,

, M.D. Piqueras

2

, I. Martínez

3

, A.L. Galdámez

4

,

A. Gil

5

, J.B. Murcia

6

, A. Belmar

4

, A. Rodríguez

4

, P. Manzur

4

,

I. Bello

4

, S. Bravo

4

, V. Ivanov

4

, C.J. García

2

1

Servicio Murciano de Salud, Centro de Salud Mental, Hospital

Universitario Santa Lucía, Cartagena, Murica, Spain

2

Servicio Murciano de Salud, Hospital Universitario Santa Lucía,

Cartagena, Murcia, Spain

3

Servicio Murciano de Salud, Residencia Psicogeriátrica Virgen del

Valle, El Palmar, Murcia, Spain

4

Servicio Murciano de Salud, Centro de Salud Mental Cartagena,

Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain

5

Servicio Murciano de Salud, Unidad Regional de Media Estancia,

Hospital Psiquiátrico Román Alberca, Murcia, Spain

6

Servicio Murciano de Salud, Centro de Salud Mental Cartagena,

Cartagena, Murcia, Spain

Corresponding author.